#FOAMed of the Week: Approach to Paeds EM via @Damian_Roland and @EM3FOAMed

This is a great PEM induction video from the #EM3 team in the East Midlands (inc Damian Roland). Its got some great clips of clinical signs you will need to recognise in unwell children. 

Some of the pattern recognition we learn in adult practice doesn't quite work as well in children. Using a structured approach if it isn't immediately apparent whats going on can help you pick your way around some of the common pitfalls. They suggest the nice traffic light system in this video. 

For more excellent PEM hints and tips check out links like this: 

http://dontforgetthebubbles.com/paediatric-emergency-medicine-monthly-foamed-review/

#FOAMed of the Week: BRUE via FOAMedCast and Don't forget the bubbles...

More Paeds this week!

I have always found the ALTE (Acute Life Threatening Events) concept a bit frustrating:

“an episode that is frightening to the observer and that is characterised by some combination of apnoea (central or occasionally obstructive), colour change…marked change in muscle tone
(usually marked limpness), choking, or gagging. In some cases, the observer fears that the infant has died.”

It seemed vague enough to include almost anything from the obviously worrying to the obviously benign and advocated a lot of admissions that seemed ovecautious.

This Month The American Academy of Paediatrics released a clinical practice guideline which recommends a different strategy which is worth being aware of - and discussing with our paeds collaegues.

ENTER THE BRUE.......

Its covered excellently by FOAMCast and Dont forget the bubbles.

#FOAMed of the Week: Undifferentiated Sick Infant via @EMtogether

So its a while since we highlighted any great PEM learning sites and I stumbled across pemplaybook.org when this episode appeared on ERcast. 

They put forward an intuitive structure to the assessment of the sick infant that appeals to me more than the usual ABCD. If you like mnemonics you're gonna love it..... Check the webpage for the notes - very helpful. 

The only caveat is that I don't think I would rush to do ABGs to pick up congenital heart disease. I was trained to start with 4 limb BP and sats..... (while frantically calling for help) but I'd be interested to hear any other approaches.